Intramedullary screw fixation for balancing of the dysvascular foot following transmetatarsal amputation.

Transmetatarsal amputation is a viable alternative to more proximal pedal amputations or leaving a deformed partial forefoot amputation. Balancing the transmetatarsal amputation in order to correct soft-tissue deformities is an accepted approach and consists of various tendon transfers, However, in the recently re-vascularized limb or in those patients who can not undergo re-vascularization, additional incisions to balance the transmetatarsal amputation are not performed. The authors present a simple and effective technique utilizing a large diameter, cannulated screw extending from the residual first metatarsal across the midfoot and into the talus after the foot has been manually corrected, which is useful for patients undergoing transmetatarsal amputation who can not undergo soft-tissue balancing.